Quality Measure Implementation Guide
1.0.0-ballot - ballot International flag

This page is part of the Quality Measure Implementation Guide (v1.0.0-ballot: STU1 (v1.0.0) Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. . For a full list of available versions, see the Directory of published versions

: EXM55 - Median Emergency Department Visit Duration - XML Representation

Active as of 2022-02-22

Raw xml | Download


<Measure xmlns="http://hl7.org/fhir">
  <id value="EXM55-FHIR"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-cvmeasure"/>
    <profile
             value="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-computablemeasure"/>
    <profile
             value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablemeasure"/>
    <profile
             value="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-cqlmeasure"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
<div>
    <table class="grid dict">
        
            <tr>
                <th scope="row"><b>Title: </b></th>
                <td style="padding-left: 4px;">EXM55 - Median Emergency Department Visit Duration</td>
            </tr>
        

        

        
            <tr>
                <th scope="row"><b>Id: </b></th>
                <td style="padding-left: 4px;">EXM55-FHIR</td>
            </tr>
        

        
            <tr>
                <th scope="row"><b>Version: </b></th>
                <td style="padding-left: 4px;">5.0.0</td>
            </tr>
        

        
            <tr>
                <th scope="row"><b>Url: </b></th>
                <td style="padding-left: 4px;"><a href="Measure-EXM55-FHIR.html">EXM55 - Median Emergency Department Visit Duration</a></td>
            </tr>
        

        
            <tr>
                <th scope="row">
                    <b>
                        
                            Official
                        
                    </b>
                </th>

                <td style="padding-left: 4px;">
                    
                        <p style="margin-bottom: 5px;">
                            <span>55</span>
                        </p>
                    
                </td>
            </tr>
        

        
            <tr>
                <th scope="row"><b>Effective Period: </b></th>
                <td style="padding-left: 4px;">2018-01-01..2018-12-31</td>
            </tr>
        

        

        
            <tr>
                <th scope="row"><b>Experimental: </b></th>
                <td style="padding-left: 4px;">true</td>
            </tr>
        

        
            <tr>
                <th scope="row"><b>Publisher: </b></th>
                <td style="padding-left: 4px;">HL7 International / Clinical Quality Information</td>
            </tr>
        

        

        

        
            <tr>
                <th scope="row"><b>Description: </b></th>
                <td style="padding-left: 4px;"><div><p>This example illustrates a continuous variable measure represented as a FHIR eCQM</p>
</div></td>
            </tr>
        

        

        

        
            <tr>
                <th scope="row"><b>Use Context: </b></th>
                <td style="padding-left: 4px;">
                    <table class="grid-dict">
                        <tr>
                            <th><b>code</b></th>
                            <th><b>value</b></th>
                        </tr>
                        
                            <tr>
                                <td>venue</td>
                                <td/>
                            </tr>
                        
                    </table>
                </td>
            </tr>
        

        
            <tr>
                <th scope="row"><b>Jurisdiction: </b></th>
                <td style="padding-left: 4px;">001</td>
            </tr>
        

        
            <tr>
                <th scope="row"><b>Topic: </b></th>
                <td style="padding-left: 4px;">57024-2</td>
            </tr>
        

        

        

        

        

        

        
            <tr>
                <th scope="row"><b>Scoring: </b></th>
                <td style="padding-left: 4px;">
                    
                        
                            <p style="margin-bottom: 5px;">
                                <span>Continuous Variable </span>
                            </p>
                        
                    
                    
                </td>
            </tr>
        

        

        
            <tr>
                <th scope="row"><b>Type: </b></th>
                <td style="padding-left: 4px;">
                    
                        
                            <p style="margin-bottom: 5px;">
                                <span>process </span>
                            </p>
                        
                    
                    
                </td>
            </tr>
        

        

        

        

        

        
            <tr>
                <th scope="row"><b>Improvement Notation: </b></th>
                <td style="padding-left: 4px;">
                    
                        
                            <p style="margin-bottom: 5px;">
                                <span>Decreased score indicates improvement </span>
                            </p>
                        
                    
                    
                </td>
            </tr>
        

        

        
            
        

        

        

        

        
            <tr>
                <th scope="row"><b>Libraries: </b></th>
                <td style="padding-left: 4px;">
                    <table class="grid-dict">
                        
                            <tr>
                                <td><a href="Library-EXM55-FHIR.html">EXM55 - Median Emergency Department Visit Duration Library (Example Continuous Variable Measure Library)</a></td>
                            </tr>
                        
                    </table>
                </td>
            </tr>
        

        

        
            
                <tr>
                    <th scope="row"><b>Terminology and Other Dependencies: </b></th>
                    <td style="padding-left: 4px;">
                        
                            <li><code>http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1</code></li>
                        
                            <li><a href="http://terminology.hl7.org/5.5.0/CodeSystem-diagnosis-role.html">Diagnosis Role</a></li>
                        
                            <li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299</code></li>
                        
                            <li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292</code></li>
                        
                            <li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126</code></li>
                        
                    </td>
                </tr>
                <tr>
                    <th scope="row"><b>Parameters:</b></th>
                    <td style="padding-left: 4px;">
                        <table class="grid-dict">
                            <tr>
                                <th><b>name</b></th>
                                <th><b>use</b></th>
                                <th><b>min</b></th>
                                <th><b>max</b></th>
                                <th><b>type</b></th>
                            </tr>
                            
                                <tr>
                                    <td>Measurement Period</td>
                                    <td>In</td>
                                    <td>0</td>
                                    <td>1</td>
                                    <td>Period</td>
                                </tr>
                            
                                <tr>
                                    <td>Stratification 3</td>
                                    <td>Out</td>
                                    <td>0</td>
                                    <td>*</td>
                                    <td>Encounter</td>
                                </tr>
                            
                                <tr>
                                    <td>Stratification 2</td>
                                    <td>Out</td>
                                    <td>0</td>
                                    <td>*</td>
                                    <td>Encounter</td>
                                </tr>
                            
                                <tr>
                                    <td>Measure Population Exclusion</td>
                                    <td>Out</td>
                                    <td>0</td>
                                    <td>*</td>
                                    <td>Encounter</td>
                                </tr>
                            
                                <tr>
                                    <td>Stratification 1</td>
                                    <td>Out</td>
                                    <td>0</td>
                                    <td>*</td>
                                    <td>Encounter</td>
                                </tr>
                            
                                <tr>
                                    <td>Initial Population</td>
                                    <td>Out</td>
                                    <td>0</td>
                                    <td>*</td>
                                    <td>Encounter</td>
                                </tr>
                            
                                <tr>
                                    <td>Measure Population</td>
                                    <td>Out</td>
                                    <td>0</td>
                                    <td>*</td>
                                    <td>Encounter</td>
                                </tr>
                            
                        </table>
                    </td>
                </tr>

                <tr>
                    <th scope="row"><b>DataRequirements:</b></th>
                    <td style="padding-left: 4px;">
                        <table class="grid-dict">
                            <tr>
                                <th><b>Resource Type</b></th>
                                <th><b>Resource Elements</b></th>
                                <th><b>Valueset Name</b></th>
                                <th><b>Valueset</b></th>
                            </tr>
                            
                                <tr>
                                    <td>Encounter(<a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>)</td>
                                    <td>
                                        
                                            period
                                        
                                            hospitalization
                                        
                                            hospitalization.admitSource
                                        
                                            type
                                        
                                            status
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Emergency Department Visit
                                            
                                        
                                    </td>
                                    <td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292</code></td>
                                </tr>
                            
                                <tr>
                                    <td>Encounter(<a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>)</td>
                                    <td>
                                        
                                            period
                                        
                                    </td>
                                    <td>
                                        
                                    </td>
                                    <td/>
                                </tr>
                            
                                <tr>
                                    <td>Condition(<a href="http://hl7.org/fhir/R4/condition.html">Condition</a>)</td>
                                    <td>
                                        
                                            id
                                        
                                    </td>
                                    <td>
                                        
                                    </td>
                                    <td/>
                                </tr>
                            
                        </table>
                    </td>
                </tr>

                

                
                    <tr>
                        <th scope="row"><b>Direct Reference Codes:</b></th>
                        <td style="padding-left: 4px;">
                            <table class="grid-dict">
                                <tr>
                                    <th><b>display</b></th>
                                    <th><b>code</b></th>
                                    <th><b>system</b></th>
                                </tr>
                                
                                    <tr>
                                        <td>Billing</td>
                                        <td>billing</td>
                                        <td><a href="http://terminology.hl7.org/5.5.0/CodeSystem-diagnosis-role.html">http://terminology.hl7.org/CodeSystem/diagnosis-role</a></td>
                                    </tr>
                                
                            </table>
                        </td>
                    </tr>
                

                
                <tr>
                    <th scope="row"><b>Logic Definitions:</b></th>
                    <td style="padding-left: 4px;">
                        
                        <table class="grid-dict">
                            <tr>
                                <th><b>Group</b></th>
                                <th><b>Scoring</b></th>
                                <th><b>Population Criteria</b></th>
                                <th><b>Expression</b></th>
                            </tr>
                            <tr>
                                
                                <td>  </td>
                                <td colspan="3" style="padding-left: 4px;">
                                    

                                    

                                    
                                        <b>Measure scoring:</b>
                                        
                                            <p style="margin-bottom: 5px;">
                                                <span>Continuous Variable</span>
                                            </p>
                                        
                                    

                                    

                                    

                                    

                                    

                                    

                                    

                                </td>
                                
                                <tr>
                                    <td/>
                                    <td/>
                                    <td>Initial Population</td>
                                    <td>
                                        
                                            <pre><code class="language-cql">define &quot;Initial Population&quot; :
  &quot;Inpatient Encounter&quot; Encounter
    with [&quot;Encounter&quot; : &quot;Emergency Department Visit&quot;] ED
     such that ED.status = 'finished'
       and ED.period ends 1 hour or less before start of Encounter.period</code></pre>
                                        
                                    </td>
                                </tr>
                                
                                <tr>
                                    <td/>
                                    <td/>
                                    <td>Measure Population</td>
                                    <td>
                                        
                                            <pre><code class="language-cql">define &quot;Measure Population&quot; :
  &quot;Initial Population&quot;</code></pre>
                                        
                                    </td>
                                </tr>
                                
                                <tr>
                                    <td/>
                                    <td/>
                                    <td>Measure Population Exclusion</td>
                                    <td>
                                        
                                            <pre><code class="language-cql">define &quot;Measure Population Exclusion&quot; :
  &quot;Inpatient Encounter&quot; Encounter
    with [&quot;Encounter&quot; : &quot;Emergency Department Visit&quot;] ED
      such that ED.period ends 1 hour or less before start of Encounter.period
        and ED.status = 'finished'
        and ED.hospitalization.admitSource in &quot;Hospital Settings&quot;</code></pre>
                                        
                                    </td>
                                </tr>
                                
                                <tr>
                                    <td/>
                                    <td/>
                                    <td>Measure Observation</td>
                                    <td>
                                        
                                            <pre><code class="language-cql"/></pre>
                                        
                                    </td>
                                </tr>
                                
                                
                                <tr>
                                    <td/>
                                    <td/>
                                    <td>Stratification 1</td>
                                    <td>
                                        
                                            <pre><code class="language-cql">define &quot;Stratification 1&quot; :
  &quot;Inpatient Encounter&quot; Encounter
    where not (PrincipalDiagnosis(Encounter).code in &quot;Psychiatric/Mental Health Patient&quot;)</code></pre>
                                        
                                    </td>
                                </tr>
                                
                                <tr>
                                    <td/>
                                    <td/>
                                    <td>Stratification 2</td>
                                    <td>
                                        
                                            <pre><code class="language-cql">define &quot;Stratification 2&quot; :
  &quot;Inpatient Encounter&quot; Encounter
    where PrincipalDiagnosis(Encounter).code in &quot;Psychiatric/Mental Health Patient&quot;</code></pre>
                                        
                                    </td>
                                </tr>
                                
                                <tr>
                                    <td/>
                                    <td/>
                                    <td>Stratification 3</td>
                                    <td>
                                        
                                            <pre><code class="language-cql">define &quot;Stratification 3&quot; :
  &quot;Inpatient Encounter&quot; Encounter
    where PrincipalDiagnosis(Encounter) is null</code></pre>
                                        
                                    </td>
                                </tr>
                                
                            
                            </tr>
                        </table>
                

                <table class="grid-dict">
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>EXM55-FHIR</td>
                            
                            
                                <td>Inpatient Encounter</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">define &quot;Inpatient Encounter&quot; :
  [&quot;Encounter&quot;] Encounter
    where LengthInDays(Encounter.period) &lt;= 120
      and Encounter.period ends during &quot;Measurement Period&quot;</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>EXM55-FHIR</td>
                            
                            
                                <td>Stratification 3</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">define &quot;Stratification 3&quot; :
  &quot;Inpatient Encounter&quot; Encounter
    where PrincipalDiagnosis(Encounter) is null</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>EXM55-FHIR</td>
                            
                            
                                <td>Stratification 2</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">define &quot;Stratification 2&quot; :
  &quot;Inpatient Encounter&quot; Encounter
    where PrincipalDiagnosis(Encounter).code in &quot;Psychiatric/Mental Health Patient&quot;</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>EXM55-FHIR</td>
                            
                            
                                <td>Measure Population Exclusion</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">define &quot;Measure Population Exclusion&quot; :
  &quot;Inpatient Encounter&quot; Encounter
    with [&quot;Encounter&quot; : &quot;Emergency Department Visit&quot;] ED
      such that ED.period ends 1 hour or less before start of Encounter.period
        and ED.status = 'finished'
        and ED.hospitalization.admitSource in &quot;Hospital Settings&quot;</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>EXM55-FHIR</td>
                            
                            
                                <td>Stratification 1</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">define &quot;Stratification 1&quot; :
  &quot;Inpatient Encounter&quot; Encounter
    where not (PrincipalDiagnosis(Encounter).code in &quot;Psychiatric/Mental Health Patient&quot;)</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>EXM55-FHIR</td>
                            
                            
                                <td>Initial Population</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">define &quot;Initial Population&quot; :
  &quot;Inpatient Encounter&quot; Encounter
    with [&quot;Encounter&quot; : &quot;Emergency Department Visit&quot;] ED
     such that ED.status = 'finished'
       and ED.period ends 1 hour or less before start of Encounter.period</code></pre>
                                </td>
                            
                        </tr>
                    
                        <tr>
                            <th><b>Library Name</b></th>
                            <th><b>Name</b></th>
                        </tr>
                        <tr>
                            
                                <td>EXM55-FHIR</td>
                            
                            
                                <td>Measure Population</td>
                            
                        </tr>
                        <tr>
                            
                                <td/>
                                <td>
                                    <pre class="highlight language-cql"><code class="language-cql">define &quot;Measure Population&quot; :
  &quot;Initial Population&quot;</code></pre>
                                </td>
                            
                        </tr>
                    
                    </table>
                </td>
            </tr>
            
        
    

    </table>
</div>
</div>
  </text>
  <contained>
    <Library>
      <id value="effective-data-requirements-exm55"/>
      <meta>
        <profile
                 value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-moduledefinitionlibrary"/>
      </meta>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/diagnosis-role"/>
          <code value="billing"/>
          <display value="Billing"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM55-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Inpatient Encounter"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Inpatient Encounter&quot; :
  [&quot;Encounter&quot;] Encounter
    where LengthInDays(Encounter.period) &lt;= 120
      and Encounter.period ends during &quot;Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="0"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM55-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Stratification 3"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Stratification 3&quot; :
  &quot;Inpatient Encounter&quot; Encounter
    where PrincipalDiagnosis(Encounter) is null"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="1"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM55-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Stratification 2"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Stratification 2&quot; :
  &quot;Inpatient Encounter&quot; Encounter
    where PrincipalDiagnosis(Encounter).code in &quot;Psychiatric/Mental Health Patient&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="2"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM55-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Measure Population Exclusion"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Measure Population Exclusion&quot; :
  &quot;Inpatient Encounter&quot; Encounter
    with [&quot;Encounter&quot; : &quot;Emergency Department Visit&quot;] ED
      such that ED.period ends 1 hour or less before start of Encounter.period
        and ED.status = 'finished'
        and ED.hospitalization.admitSource in &quot;Hospital Settings&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="3"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM55-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Stratification 1"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Stratification 1&quot; :
  &quot;Inpatient Encounter&quot; Encounter
    where not (PrincipalDiagnosis(Encounter).code in &quot;Psychiatric/Mental Health Patient&quot;)"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="4"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM55-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Initial Population"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Initial Population&quot; :
  &quot;Inpatient Encounter&quot; Encounter
    with [&quot;Encounter&quot; : &quot;Emergency Department Visit&quot;] ED
     such that ED.status = 'finished'
       and ED.period ends 1 hour or less before start of Encounter.period"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="5"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXM55-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Measure Population"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Measure Population&quot; :
  &quot;Initial Population&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="6"/>
        </extension>
      </extension>
      <url
           value="http://hl7.org/fhir/uv/cqm/Library/effective-data-requirements-exm55"/>
      <version value="1.0.0"/>
      <name value="ModuleDefinitionLibraryEXM55"/>
      <title value="Module Definition Library - EXM55"/>
      <status value="active"/>
      <experimental value="true"/>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/library-type"/>
          <code value="module-definition"/>
        </coding>
      </type>
      <date value="2022-02-22T10:37:03-07:00"/>
      <description
                   value="This library is used as an example module definition in the FHIR Quality Measure Implementation Guide"/>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library FHIRHelpers"/>
        <resource
                  value="http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system Diagnosis Role"/>
        <resource
                  value="http://terminology.hl7.org/CodeSystem/diagnosis-role"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Psychiatric/Mental Health Patient"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Emergency Department Visit"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Hospital Settings"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126"/>
      </relatedArtifact>
      <parameter>
        <name value="Measurement Period"/>
        <use value="in"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Period"/>
      </parameter>
      <parameter>
        <name value="Stratification 3"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Encounter"/>
      </parameter>
      <parameter>
        <name value="Stratification 2"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Encounter"/>
      </parameter>
      <parameter>
        <name value="Measure Population Exclusion"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Encounter"/>
      </parameter>
      <parameter>
        <name value="Stratification 1"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Encounter"/>
      </parameter>
      <parameter>
        <name value="Initial Population"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Encounter"/>
      </parameter>
      <parameter>
        <name value="Measure Population"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Encounter"/>
      </parameter>
      <dataRequirement>
        <type value="Encounter"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <mustSupport value="period"/>
        <mustSupport value="hospitalization"/>
        <mustSupport value="hospitalization.admitSource"/>
        <mustSupport value="type"/>
        <mustSupport value="status"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <mustSupport value="period"/>
      </dataRequirement>
      <dataRequirement>
        <type value="Condition"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
        <mustSupport value="id"/>
        <codeFilter>
          <path value="id"/>
        </codeFilter>
      </dataRequirement>
    </Library>
  </contained>
  <extension
             url="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis">
    <valueCode value="Encounter"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem">
    <valueReference>🔗 
      <reference value="Device/software-system-example"/>
    </valueReference>
  </extension>
  <extension
             url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements">
    <valueCanonical value="#effective-data-requirements-exm55"/>
  </extension>
  <url value="http://hl7.org/fhir/uv/cqm/Measure/EXM55-FHIR"/>
  <identifier>
    <use value="official"/>
    <system value="http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm"/>
    <value value="55"/>
  </identifier>
  <version value="5.0.0"/>
  <name value="EXM55"/>
  <title value="EXM55 - Median Emergency Department Visit Duration"/>
  <status value="active"/>
  <experimental value="true"/>
  <date value="2022-02-22"/>
  <publisher value="HL7 International / Clinical Quality Information"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/cqi"/>
    </telecom>
  </contact>
  <description
               value="This example illustrates a continuous variable measure represented as a FHIR eCQM"/>
  <useContext>
    <code>
      <system
              value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
      <code value="venue"/>
      <display value="Venue"/>
    </code>
    <valueCodeableConcept>
      <coding>
        <system
                value="http://hl7.org/fhir/uv/cqm/CodeSystem/intended-venue-codes"/>
        <code value="eh"/>
        <display value="EH"/>
      </coding>
    </valueCodeableConcept>
  </useContext>
  <jurisdiction>
    <coding>
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
      <code value="001"/>
    </coding>
  </jurisdiction>
  <approvalDate value="2019-03-08"/>
  <lastReviewDate value="2019-03-08"/>
  <effectivePeriod>
    <start value="2018-01-01"/>
    <end value="2018-12-31"/>
  </effectivePeriod>
  <topic>
    <coding>
      <system value="http://loinc.org"/>
      <code value="57024-2"/>
      <display value="Health Quality Measure Document"/>
    </coding>
  </topic>
  <library value="http://hl7.org/fhir/uv/cqm/Library/EXM55-FHIR"/>
  <scoring>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
      <code value="continuous-variable"/>
      <display value="Continuous Variable"/>
    </coding>
  </scoring>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
      <code value="process"/>
    </coding>
  </type>
  <improvementNotation>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
      <code value="decrease"/>
      <display value="Decreased score indicates improvement"/>
    </coding>
  </improvementNotation>
  <group>
    <population>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="initial-population"/>
          <display value="Initial Population"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Initial Population"/>
      </criteria>
    </population>
    <population>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="measure-population"/>
          <display value="Measure Population"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Measure Population"/>
      </criteria>
    </population>
    <population>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="measure-population-exclusion"/>
          <display value="Measure Population Exclusion"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Measure Population Exclusion"/>
      </criteria>
    </population>
    <population>
      <extension
                 url="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-criteriaReference">
        <valueString value="measure-population-identifier"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-aggregateMethod">
        <valueCode value="median"/>
      </extension>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="measure-observation"/>
          <display value="Measure Observation"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Measure Observation"/>
      </criteria>
    </population>
    <stratifier>
      <extension
                 url="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo">
        <valueCodeableConcept>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/measure-population"/>
            <code value="initial-population"/>
            <display value="Initial Population"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <code>
        <coding>
          <system value="http://example.org/stratification"/>
          <code value="Stratification 1"/>
          <display value="Stratification 1"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Stratification 1"/>
      </criteria>
    </stratifier>
    <stratifier>
      <extension
                 url="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo">
        <valueCodeableConcept>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/measure-population"/>
            <code value="initial-population"/>
            <display value="Initial Population"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <code>
        <coding>
          <system value="http://example.org/stratification"/>
          <code value="Stratification 2"/>
          <display value="Stratification 2"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Stratification 2"/>
      </criteria>
    </stratifier>
    <stratifier>
      <extension
                 url="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo">
        <valueCodeableConcept>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/measure-population"/>
            <code value="initial-population"/>
            <display value="Initial Population"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <code>
        <coding>
          <system value="http://example.org/stratification"/>
          <code value="Stratification 3"/>
          <display value="Stratification 3"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Stratification 3"/>
      </criteria>
    </stratifier>
  </group>
</Measure>